McLeod N M H, Van Gijn D
Oxford University Hospitals NHS Foundation Trust, Department of Oral & Maxillofacial Surgery, The John Radcliffe, Headley Way, Oxford OX3 9DU, UK.
Oxford University Hospitals NHS Foundation Trust, Department of Oral & Maxillofacial Surgery, The John Radcliffe, Headley Way, Oxford OX3 9DU, UK.
Br J Oral Maxillofac Surg. 2018 Apr;56(3):182-185. doi: 10.1016/j.bjoms.2018.01.003. Epub 2018 Feb 7.
The need to treat fractures of the mandibular condyle remains controversial, but when the decision to operate has been made, then multiple forms of fixation are advocated. Traditionally, metal plates and screws have been used, but this is thought to have several disadvantages, particularly in the growing skeleton. Resorbable fixation for maxillofacial fractures has not gained widespread acceptance because of technical difficulties with the materials and concern about inflammatory reactions during their resorption. Because not all patients have typical fracture patterns that fit the size and shape of metal plates, mouldable resorbable fixation materials can be useful, and ultrasound-activated resorbable sheets and pins have the necessary stability to fix fractures of the condylar neck. We present a series of patients in whom ultrasound-activated resorbable sheets and pins were used to fix condylar fractures in which the fracture pattern did not permit the use of stable metal fixation, or the age of the patient in our opinion precluded the use of metal fixation. There were no perioperative complications and no problems related to the stability of the fixation. Minor swelling relating to the resorption of the material in one case did not require any management.
下颌髁突骨折的治疗需求仍存在争议,但一旦决定进行手术,便提倡多种固定方式。传统上一直使用金属板和螺钉,但人们认为这存在若干缺点,尤其是在骨骼仍在生长的情况下。由于材料存在技术难题以及对其吸收过程中炎症反应的担忧,可吸收固定材料在颌面骨折治疗中尚未得到广泛应用。因为并非所有患者都具有适合金属板尺寸和形状的典型骨折模式,所以可塑形的可吸收固定材料可能会很有用,而超声激活的可吸收片材和针具有固定髁突颈部骨折所需的稳定性。我们报告了一系列使用超声激活的可吸收片材和针来固定髁突骨折的患者,这些患者的骨折模式不适合使用稳定的金属固定,或者在我们看来患者的年龄不适合使用金属固定。术中无并发症,固定稳定性方面也没有问题。有一例因材料吸收导致轻微肿胀,但无需特殊处理。